Hiv Patients | The View From The Other Side Of The Desk
As a patient at a large integrated delivery system (IDS), I often get frustrated with the lack of “connectedness” within the system. Scheduling appointments is challenging, as the locations are quite some distance apart. Knowing where each specialty provider is located can be like working through a labyrinth. When I call the provider office to schedule an appointment, check lab results, etc., and if I do not have my clinic number handy, I can expect a heavy sigh on the other end of the phone. I often wondered why the IDS hadn’t yet gotten on board with an electronic medical record (EMR).
So a few months back when I arrived for my appointment only to be told, “Patients check in on each floor now,” I knew something was up! Sure enough, the IDS has moved into the 21st century and is implementing a “new system”. As a healthcare IT wonk, and one who has a direct interest in unified patient information management, I started to think that going to the doctor could actually be fun – if not interesting. I would be “e-patient Peg!”
The excitement quickly wore off when I saw the frustration on the faces of the staff at the patient registration desk and their impatience – no pun intended — with patients who were also quite confused. Ironically, this IDS sends paper notifications to patients constantly. So why didn’t they send me a notification about the implementation of this new system and how it would change the patient check-in process, or other patient interactions? It would have certainly made the check-in process better for all involved. It would have also been an opportunity for the organization to market this great technology leap as an opportunity to improve care across the entire IDS.
As I completed check in and was ushered into the actual appointment, I thought, “I wonder who will use the EMR next?” The answer? Not one person I saw! All the clinicians I met with, including the physician, used paper, even though the state of the art laptop was propped up on the exam room desk, in plain sight. Everything from the complaint to vital signs to notes and orders was handwritten on various sheets of paper. This lack of integration was fascinating to me. As the orders were written, I could not help but mention my personal interest in healthcare IT. I said to the doctor: “I work in healthcare technology and my primary role revolves around the successful use of technology in the physician office. I find the process of EMR implementation and integration particularly interesting, and I see that your organization now has an EMR. So I couldn’t help but notice that you are not using the computer at all. You are even writing your orders on paper.”
Typically, when I talk to providers about topics such as this it sparks some sort of interest and response from them. I become a sounding board, a complaint desk, a person who they can vent to. This is what I live for – listening to provider concerns and helping them address office management challenges is nectar of the gods for someone like me. But in this case all I got was a cold and icy stare. It made me uncomfortable. Should I have kept my mouth shut? Did I insult the doctor?
In the last few years, I have noticed a trend in EMR implementations: Provider organizations have targeted staff members who already use the organizations’ existing practice management (PM) system as “early adopters” of the new EMR system. Why? Because these staffers are often the most experienced in using technology to support and drive their daily workflows. For example, today, the PM system often drives the workflows for staff who manage scheduling, check in, check out and billing. So it is easy to see why these same dedicated staffers are now expected to be the first to use the new EMR. The irony is that although many of these staff members are certainly patient-facing, they actually have little to nothing to do with the actual care patients receive or decisions made around that care. I know I would prefer that my doctor was using the EMR versus the woman who takes my co-payment. I would prefer to know that my medical record was being viewed, not just my payment history.
The healthcare industry needs a viable solution to address the patient data “silo” conundrum. Patient-centric administrative, financial and clinical is all related. Wouldn’t it be great if physician offices had an easy-to-use all-in-one, fully integrated solution to help them manage patient information from a single access point? In practice, this means integrating the practice management (PM) system with the EMR, and in turn connecting those systems to the ones that facilitate communications with health plans. A unified platform for accomplishing administrative, financial and clinical tasks would enable physicians to concentrate on delivering higher quality care while improving the efficiency and effectiveness of the business side of their practice.
The good news is that help is on the way. Stay tuned for news from NaviNet about our new unified patient information management system. In the meantime, I’ll be waiting to see if my e-script has made it to the pharmacy that I selected.
Regards,
Peggy Denness
Director of Provider Advocacy
